<div class="row">
    <div class="col-md-6">
        <div class="mb-3">
            <label for="instrument_name" class="form-label">仪器名称:</label>
            <select class="form-control" id="instrument_name"
                    name="instrument_name"
                    required>
                <option value="T5">T5</option>
                <option value="T7">T7</option>
                <option value="T9">T9</option>
                <option value="T50">T50</option>
                <option value="T70">T70</option>
                <option value="T90">T90</option>
            </select>
        </div>
    </div>
    <div class="col-md-6">
        <label class="form-label">仪器固件版本:</label>
        <input class="form-control" name="instrument_version"/>
    </div>
    <div class="col-md-6">
        <div class="mb-3" style="margin-top:20px;">
            <label for="instrument_serial" class="form-label">仪器序列号:</label>
            <input type="text" class="form-control" id="instrument_serial"
                   name="instrument_serial"
                   required>
        </div>
    </div>
</div>

<table class="table table-condensed" style="margin-top:20px; font-size: 12px;">
    <tr style="padding: 10px;">
        <th style="width: 200px;">项目</th>
        <th style="width: 50px;">检查</th>
        <th style="width: 50px;">清洁</th>
        <th style="width: 50px;">更换</th>
        <th style="width: 50px;">是否执行</th>
    </tr>
    <tr>
        <td>电源线</td>
        <td>X</td>
        <td></td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F1">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>外接电源插座</td>
        <td>X</td>
        <td></td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F2">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>开关键</td>
        <td>X</td>
        <td>X</td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F3">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>固定螺丝</td>
        <td>X</td>
        <td></td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F4">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>设备背部接口</td>
        <td>X</td>
        <td>X</td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F5">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>主机外壳</td>
        <td>X</td>
        <td>X</td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F6">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>内部驱动器(清洁/润滑)</td>
        <td>X</td>
        <td>X</td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F7">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>三通阀(需拆卸)</td>
        <td>X</td>
        <td>X</td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F8">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>内部电子元器件板</td>
        <td>X</td>
        <td>X</td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F9">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>

    <tr style="padding: 50px;">
        <td>滴定臂</td>
        <td>X</td>
        <td>X</td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F10">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>搅拌器/桨叶</td>
        <td>X</td>
        <td>X</td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F11">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>电极(清洁/活化)</td>
        <td>X</td>
        <td>X</td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F12">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>


    <tr style="padding: 50px;">
        <td>保护罩</td>
        <td>X</td>
        <td>X</td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F13">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>显示屏</td>
        <td>X</td>
        <td>X</td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F14">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>


    <tr style="padding: 50px;">
        <td>驱动单元外壳</td>
        <td>X</td>
        <td>X</td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F15">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>外接驱动器(清洁/润滑)</td>
        <td>X</td>
        <td>X</td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F16">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>溶剂管理器</td>
        <td>X</td>
        <td>X</td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F17">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>


    <tr style="padding: 50px;">
        <td>触摸屏保护罩和瓶口密封(部分型号)</td>
        <td></td>
        <td></td>
        <td>
            <select>
                <option value=""></option>
                <option value="X" selected>X</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
        <td>
            <select name="F18">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>


    <tr style="padding: 50px;">
        <td>主板</td>
        <td>X</td>
        <td></td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F19">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>模拟板</td>
        <td>X</td>
        <td></td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F20">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>电导率板</td>
        <td>X</td>
        <td></td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F21">
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
                <option value="N/A" selected>N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>库伦板</td>
        <td>X</td>
        <td></td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F22">
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
                <option value="N/A" selected>N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>内部驱动器</td>
        <td>X</td>
        <td></td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F23">
                <option value=""></option>
                <option value="是" selected>是</option>
                <option value="否">否</option>
                <option value="N/A">N/A</option>
            </select>
        </td>
    </tr>
    <tr style="padding: 50px;">
        <td>外接驱动单元</td>
        <td>X</td>
        <td></td>
        <td>
            <select>
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
            </select>
        </td>
        <td>
            <select name="F24">
                <option value=""></option>
                <option value="是">是</option>
                <option value="否">否</option>
                <option value="N/A" selected>N/A</option>
            </select>
        </td>
    </tr>

</table>
